Gap Cover – What is Gap Cover? Why do I need Gap Cover? How can I get Gap Cover?

Many people purchase a medical scheme membership and assume it will cover all their medical expenses. This is rarely true and that’s why you need GapCover. We have answered all your questions here:

What is Gap Cover for medical aid members?

GapCover offers expense shortfall cover if the amount that has been charged by a Registered Medical Professional does not match the Medical Scheme Tariff paid by your medical aid. This amount is paid from risk for services that you would have received at a hospital. Gap cover for medical aid members covers up to five times more than the medical scheme tariff usually covered by your medical scheme.

For affordable gap cover GapRisk offers GapCover® for individuals at a very low monthly premium.

Are you wondering “Can I get gap cover for my whole family” or “What does GapCover for my whole family cost?”, then look no further! For those wanting to cover the whole family, it would cost just a bit more than the individual premium to have them added to your policy. You can add one spouse and up to four children to the same policy.

Let’s answer your next question:

Why do I need gap cover?

The truth is that many people are not aware that medical aid schemes often have shortfalls that have to be paid by the policyholder. Shortfalls happen because the service providers are able to charge more than the medical scheme covers or has agreed to pay for services provided while you are receiving treatment in hospital. Many Hospital and Comprehensive Medical Plans cover 100% to 200% of medical scheme rates but this is often only for hospitalisation. Although this might sound like a safety net, the actual costs are sometimes more than 500% of medical scheme rates. This is why adding gap cover to your medical aid cover is essential.

Unfortunately, there can’t be GapCover®, with no waiting period, because that would mean everyone with a medical problem will wait until the last minute to take up cover, leaving no funds to take care of those that have been proactive with getting Gap Cover even when they don’t yet need it. Our advice is not to leave it until it’s too late. Be ready for one day when you may need to take care of the shortfall between what your medical scheme offers and the bill you receive after your hospital stay.

How to get gap cover in South Africa

At GapRisk, we are able to offer you the necessary gap cover for medical aid. Our GapRisk Administrators are capable of meeting your needs to offer you the best medical gap cover in South Africa. Get in contact with us by calling 087 820 0627 or emailing us at